| NPI | 1447430558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OK 373) |
| Additional Taxonomies | 174400000X Specialist (Licence: OK 373) |
| Enumeration Date | 2007-11-06 |
| Last Update Date | 2019-06-06 |